Download PDF (720.25 KB) - ReliefWeb

More documents

Recommendations

Info

06 from emergency to recovery © Tugela Ridley Training midwives for safer deliveries Maternal mortality rates in Liberia are among the highest in the world. According to the World Health Organisation, Liberian women face a one in 16 lifetime risk of dying from pregnancyrelated causes. This is why maternal and child health has become an integral part of Merlin's work in Liberia. Because of the lack of professional maternal care services, leading female members of the community take on the role of midwife. These women have had no formal medical training, and rely on knowledge that has been handed down through generations. They are, however, well respected, and many women prefer to seek their services rather than to deliver at health facilities. Merlin offers a six-month training programme for traditional midwives, as well as refresher courses for those who wish to keep their skills up to date, with the aim of reducing maternal deaths. Over the past decade, more than 20,000 women have received training through Merlin initiatives. Trainee traditional midwife Gbatee Kollie (pictured, above right) says, “The more I can learn, the more I can help my Liberian sisters.” The height of the conflict In 2003, renewed fighting forced the suspension of Merlin’s programmes in Sinoe and Rivercess. As rebel groups rampaged through the country, their attention began to turn towards Monrovia. Merlin’s operations there in the second half of 2003 have been acclaimed for the courageous actions of staff during what would be the culmination of the war. In June, rebels launched two offensives – later nicknamed ‘World War One’ and ‘World War Two’ – on the capital, both of which were repelled by government forces. July saw the arrival of ‘World War Three’. A ceasefire agreed upon in Ghana was broken and chaos ensued. More than 600,000 people fled their homes and an estimated 1,000 civilians were killed. The street scenes in Monrovia – frightened civilians walking amid piles of severed bodies - were nothing short of horrific. Under the leadership of Country Director Magnus Wolfe-Murray and Medical Co-ordinator Dr Clement Peter, Merlin worked in extremely intense and, at times, harrowing circumstances. Barrie Cherinoh, employed by Merlin as an ambulance driver at the time, recalls the dangers they faced: “The Country Director and Medical Co-ordinator were so courageous. Whenever there was shelling, they said, ‘Let’s go there’. “I can’t say how many lives we saved, but it was more than a thousand. At the time it was very dangerous, but we were relief workers. We had to do it. Sometimes we wanted to escape it, because it’s not easy when you see people dying all around you.” Sumo Goyah, who had moved from Merlin’s programme in Rivercess to join the team in the capital, explains how they responded wherever they were needed: “As soon as we saw a group of 1,000 or 2,000 displaced people in one area, we opened mobile clinics. We were giving water, building latrines, treating minor illnesses. If people were severely wounded then we took them to the hospital. We were also managing outbreaks of cholera, and helping women deliver babies.” “We were the only international NGO in the town centre. It was based on our performance here that Merlin went on to be regarded as one of the major NGOs in Liberia.” Meanwhile in Harbel, Margibi County, Merlin supported eight mobile and static clinics with medical supplies, water and sanitation. And in Buchanan, Grand Bassa County, Merlin was the only NGO responding to health needs at the height of the conflict. Between July and October 2003, Merlin’s operations directly benefited nearly a quarter of a million people in these three counties.
07 10 years of health care in Liberia Recovery and rehabilitation Liberia’s 14-year war finally ended after Charles Taylor was forced into exile and a peace agreement was signed in August 2003. Two months later, a transitional government was formed and a United Nations peacekeeping force was deployed. Since the end of the conflict, Merlin’s operations in Liberia have expanded significantly and are now focused on building up the Ministry of Health and Social Welfare’s capacity. While continuing support for health facilities in Montserrado, Grand Bassa and Grand Gedeh, Merlin entered Maryland County in 2004 to help the health authorities to respond to a cholera outbreak. An isolation unit was set up at J.J. Dossen Memorial Hospital in Harper, water supplies were chlorinated and health education was conducted, thus helping to contain the outbreak and undoubtedly saving many lives. After responding to cholera, Merlin turned its attention to the ruined structure of J.J. Dossen hospital and undertook extensive renovation and repairs. The hospital was officially reopened to the public in January 2006, providing a wide range of services including outpatient care, 24-hour emergency services, paediatric and maternity care, surgery and HIV counselling and testing. In 2006, Merlin began its tenth year of operations in Liberia. Although the inauguration of President Ellen Johnson-Sirleaf had created a climate of increasing optimism, deep-rooted problems remained, including a legacy of sexual violence. Throughout 14 years of conflict, rape was used as a weapon of war and the problem remains widespread. A survey conducted in six counties found that three out of every four women had been raped. 2 From 2006, Merlin began training health staff on the management and referral of rape cases. As a prominent member of a government taskforce, Merlin started helping to standardise reporting and data collection on sexual violence across the country. Building up the capacity of Ministry staff has been one of Merlin's greatest challenges and successes. In 2006, Merlin organised a workshop to develop the management capacity of County Health Teams. This was attended by 30 representatives from all 15 counties, and resulted in a standardised management manual – an example of how Merlin is helping to build a sustainable health system. In early 2007, a new resource centre for the Ministry, equipped and supported by Merlin, was officially opened. The centre is used to train health personnel and to assist in the development of a national database for health statistics. 2007 also marked Merlin’s return to Sinoe, and its expansion of activities in Grand Bassa. These additions meant that, 10 years on from its initial intervention in Liberia, Merlin’s support of health services had extended to cover a third of the population. This included supporting 41 clinics and four hospitals in five counties. 2 International Women’s Day: Women in the Developing World factsheet, UK’s Department for International Development, March 2007 HIV counselling and testing Accurate data on the prevalence of HIV and AIDS in Liberia is scant, but there is little doubt that the overall infection rate is rising. The Joint United Nations Programme on HIV and AIDS estimates that the HIV prevalence rate among adults in Liberia is between two and five per cent. Merlin has been working in close collaboration with Liberia’s National AIDS Control Programme and has established eight voluntary counselling and testing (VCT) centres in four counties to date. A further 11 VCT centres will be established by the end of 2008. In Montserrado, Kulubor Wilson (pictured, above left) heads up HIV and AIDS services at a Merlin-supported clinic. In addition to offering free testing and sexual health education, the clinic acts as a referral centre from which people go on to obtain treatment from hospitals. “Telling people their result if they are HIV positive can be very tough. Sometimes people will sit there and start to cry,” says Kulubor. “Some people will listen to what I say, but others will look at me and say, ‘I’m finished’. I tell them that they are not finished, that they still have a life ahead of them and that they must take precautions in the future.” © Tugela Ridley
Page 1 and 2: from emergency to recovery 10 years
Page 3 and 4: 03 10 years of health care in Liber
Page 5: 05 10 years of health care in Liber
Page 9 and 10: 09 10 years of health care in Liber
Page 11 and 12: 332 health workers trained, and hea

Download PDF (720.25 KB) - ReliefWeb

Create successful ePaper yourself

Delete template?

Save as template?